Entrapment of pulmonary artery catheter in a suture at the inferior vena cava cannulation site

Entrapment of a pulmonary artery catheter (Swan-Ganz catheter) in the heart, vena cava, or pulmonary artery is a very rare and serious complication that may lead to life-threatening complications such as cardiac rupture, pulmonary artery rupture, cardiac tamponade, among others, if not recognized and treated early. We report entrapment of a Swan-Ganz catheter in the purse-string suture at the inferior vena cava cannulation site for a patient undergoing aortic valve replacement. This situation required a repeat sternotomy to release the pulmonary artery catheter.     

Soluble TGFbeta type II receptor gene therapy ameliorates acute radiation-induced pulmonary injury in rats

PURPOSE: To assess whether administration of recombinant human adenoviral vector, which carries soluble TGFbeta1 Type II receptor (TbetaRII) gene, might reduce the availability of active TGFbeta1 and thereby protect the lung from radiation-induced injury. METHODS AND MATERIALS: Female Fisher 344 rats were given a single 30 Gy dose of right hemithoracic irradiation 24 h after the injections of control (AdGFP) or treatment (AdexTbetaRII-Fc) vectors. Different end points were assessed to look for lung tissue damage. RESULTS: There was a significant increase in the plasma level of soluble TbetaRII 24 h and 48 h after injection of treatment vector. In the radiation (RT) + AdexTbetaRII-Fc group, there was a significant reduction in respiratory rate at 4 weeks after treatment as compared to the RT-alone group. Histologic results revealed a significant reduction in lung damage and decrease in the number and activity of macrophages in the RT + AdexTbetaRII-Fc group as compared to the RT-alone group. The tissue level of active TGFbeta1 was significantly reduced in rats receiving RT + AdexTbetaRII-Fc treatment. There was also an upregulation of transmembrane TbetaRII in lung tissue in the RT-alone group as compared to the RT + gene therapy rats. CONCLUSIONS: This study shows the ability of AdexTbetaRII-Fc gene therapy to induce an increase in circulating levels of soluble receptors, to reduce the tissue level of active TGFbeta1, and consequently to ameliorate acute radiation-induced lung injury.     

A histological and immunohistological study of cervical intraepithelial neoplasia in relation to recurrence after local treatment

Summary. A retrospective histological study was performed on 23 patients who had presented with recurrent cervical intraepithelial neoplasia (CIN) 18 months or more after apparently adequate local destructive treatment and a comparable control group of 23 patients who had no recurrence at 18 months. All recurrences were in women with CIN 3. Detailed examination of pretreatment biopsies showed that there were significant differences in both the extent of crypt involvement ( P <0.01) and maximum depth of CIN (P<0.01) between the recurrent groups and the comparison group of women without recurrence. There was also a significant difference in mitotic count between the two groups ( P <0.01). Immunocytoehemical staining for Langerhans' cells or human papilloma virus common antigen showed no significant difference between the two groups. A mitotic count of 35 per ten high-power fields or a depth of crypt involvement > 1.7 mm in the pretreatment biopsy was invariably associated with recurrence and identified 13/22 (59%) cases of recurrent disease. The histological reporting of these features may be of value in predicting a group of women at high risk of recurrence of CIN after local treatment.     

A 10 year review of systemic lupus erythematosus in Singapore children

A 10 year retrospective analysis of the clinical features and survival of 24 Singapore children with systemic lupus erythematosus was made. The female to male sex ratio was 11:1. The median age at diagnosis was 9.3 years (range: 3.5–17.6 years), and the median duration of follow-up was 3.6 years (range: 3 months - 10 years). The common modes of presentation were prolonged fever and malar rash (both 46%). Renal involvement (71 %) was frequent. There were six deaths, three from chronic renal failure, two from infection, and one from carditis. The overall survival at 5 years was 0.800 (s.e.m. = 0.090), and at 10 years 0.698 (s.e.m. = 0.103). The survival for lupus nephritis was 0.727 at 5 years (s.e.m. = 0.116), and 0.586 at 10 years (s.e.m. = 0.130). Although the 5 year survival rate is comparable with other series, there were more deaths after the first 5 years, and morbidity from the disease as well as from therapy was considerable.     

脑星形细胞瘤微血管密度与临床病理的关系

目的：探讨星形细胞瘤微血管密度与其临床病理的关系。方法：采用免疫组织化学S－P法，对血管内皮细胞行第八因子相关抗原（FⅧRAg）染色，然后测定微血管密度（MVD）。结果：MVD与患者性别、肿瘤生长部位、大小无明显相关；不同病理组织学级别间MVD差异有显著性（P＜0.05)，病理级别越高，MVD越大；瘤周水肿程度不同的星形细胞瘤之间，MVD差异有显著性（P＜0.01)；复发患者MVD高于未复发患者（P＜0.01)。结论：星形细胞瘤MVD与病理级别、术后复发及瘤周组织水肿关系密切，可作为一项有意义的预后指标。     

颈动脉体瘤的DSA诊断

目的加深对颈动脉体瘤 DSA 表现特点的认识,探讨其诊断与介入治疗价值。方法由两名有经验的放射学医师按双盲法对12例动脉体瘤的 DSA 造影资料进行回顾性分析,然后共同讨论并达成一致意见。结果 DSA 均能明确诊断。所有患者均见颈动脉分叉角度增大,颈内、外动脉移位;大部分瘤体以颈外动脉供血为主,血供较丰富; 6例患者瘤体包绕颈动脉者可见局部血管受侵。2例患者栓塞后造影见肿瘤染色范围缩小,且术中出血明显减少。结论 DSA 是颈动脉体瘤的诊断和术前评估的有效手段。术前栓塞有利于减少术中出血。     

肝脓肿11例CT误诊分析

肝脓肿是临床较常见的疾病,ＣＴ检查是诊断肝脓肿最敏感和最准确的方法之一［１～５］。本文对１１例肝脓肿ＣＴ误诊病例的误诊原因进行分析。１临床资料１．１一般资料１１例中男８例,女３例;年龄１７～６４岁,平均４５岁。主要临床表现为发热、畏寒、右上腹疼痛、肝...     

Trastuzumab in combination with PEGylated interferon-α1b exerts synergistic antitumor activity through enhanced inhibition of HER2 downstream signaling and antibody-dependent cellular cytotoxicity

The anti-HER2 monoclonal antibody trastuzumab is the mainstay of treatment for HER2-positive breast and gastric cancer, and its combination with multiple chemotherapeutic agents has represented an effective and rational strategy in the clinic. In this study, we report that trastuzumab in combination with PEGylated interferon-α1b (IFN-α1b), a polyethylene glycol (PEG)-conjugated form of a subtype of interferon alpha (IFN-α), synergistically inhibited the proliferation of HER2-positive cells, including BT-474 and SK-BR-3 breast cancer cells and NCI-N87 gastric cancer cells, and also induced their apoptosis, but had no effect on HER2-negative MDA-MB-231 breast cancer cells. Trastuzumab inhibited phosphorylation of HER2, AKT and ERK, an effect that was enhanced by PEGylated IFN-α1b, likely owing to PEGylated IFN-α1b-mediated downregulation of HER2 through the lysosomal degradation pathway. Moreover, PEGylated IFN-α1b significantly enhanced trastuzumab-mediated antibody-dependent cellular cytotoxicity (ADCC) in HER2-positive cells. Importantly, trastuzumab combined with PEGylated IFN-α1b exhibited significant synergistic antitumor activity in HER2-positive BT-474 xenografts, an effect that was associated with enhanced inhibition of HER2 expression and AKT and ERK phosphorylation. Strikingly, depletion of natural killer cells with anti-Asialo GM1 antibody abrogated the synergistic antitumor activity, indicating that augmented ADCC is essential for this synergy. Taken together, our findings indicate that both enhanced inhibition of HER2 downstream signaling and augmented ADCC contribute to the synergistic antitumor activity of trastuzumab with PEGylated IFN-α1b, and imply that combining trastuzumab with PEGylated IFN-α1b could be a promising strategy for HER2-positive cancers.     

急性脑梗死患者血清高敏C-反应蛋白和D-二聚体水平变化及临床意义

目的:探讨急性脑梗死患者血清高敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP),D-二聚体(D-dimer)变化及其在脑梗死中的临床意义。方法:选择48例脑梗死患者,测量其急性期和恢复期hs-CRP,D-dimer水平变化,并与30例健康对照组做比较。结果:48例急性脑梗死(ACI)患者急性期与恢复期hs-CRP、D-dimer水平均高于健康对照组,比较均有显著性差异(P<0.01);病情重者升高更明显。结论:hs-CRP、D-dimer水平升高可作为脑梗死急性期的诊断预测指标。     

携带hTERT-P2A-EGFP基因真核表达质粒的构建和鉴定

目的：构建真核表达质粒hTERT-P2A-EGFP,探讨其在HEK293FT细胞中的表达和转染效率。方法：利用pBABE-puro-hTERT和pRRLSIN-cPPT-MSCV-EGFP质粒构建重组质粒。以该质粒为模板采用PCR法获取hTERT、P2A和EGFP基因,采用重叠PCR法获得目的片段hTERT-P2A-EGFP,经酶切后目的片段与真核表达载体pRRLSIN-cPPT-MSCV-EGFP连接,得到并鉴定含有hTERT-P2A-EGFP基因的重组质粒。经脂质体介导重组质粒转染到HEK293FT细胞,荧光显微镜观察绿色荧光蛋白（GFP）在细胞中的表达。结果：PCR检测目的基因hTERT、P2A和EGFP的片段长度分别为3400、110和720 bp。酶切后目的基因片段hTERT-P2A-EGFP约4300 bp。测序分析,目的基因1547位点发生了突变。利用定点突变技术成功诱变,再次测序后目的基因序列与 GenBank 公布的基因序列完全一致。重组质粒转染HEK293FT细胞后在荧光显微镜下可以观察到GFP。流式细胞术检测,重组质粒转染HEK293FT细胞的效率为44.8%。结论：成功构建携带目的基因hTERT-P2A-EGFP的重组质粒,且可用于细胞转染。